What are common exclusions in pet insurance policies?
Written by
Victoria Hayes
Reviewed by
Prof. Henry Webster, Ph.D.Teaching you about policy exclusions can prevent unexpected claim denials and financial surprises. To be clear, all standard pet insurance policies come with certain limitations that all pet owners should be aware of. These exclusions help insurers keep costs reasonable while still providing necessary coverage, and knowing what's not included enables you to plan accordingly.
Pre-existing Conditions
- Conditions documented before enrollment
- Includes symptoms during waiting periods
- Chronic issues like diabetes or arthritis
- Curable conditions may become eligible after symptom-free periods
Routine & Preventive Care
- Vaccinations and annual check-ups
- Flea/tick prevention medications
- Teeth cleanings without medical need
- Nail trims and grooming services
- Coverage available through separate wellness add-ons
Breeding & Pregnancy
- Prenatal care and breeding fees
- Whelping or queening assistance
- Neonatal care for newborn pets
- Cesarean sections unless medically necessary
- Fertility treatments or artificial insemination
Cosmetic and elective surgeries are absolute exclusions. Tail docking purely for cosmetic reasons is never covered. Declawing is not covered unless a medical need exists. General cosmetic procedures are specifically and universally excluded. These procedures do not satisfy the typical definitions of medical coverage.
Evidence of appropriate medical documentation is required for any behavioral training. Basic obedience classes will still not be covered. Coverage applies only when a certified veterinary behaviorist makes the diagnosis. Therapy for separation anxiety will be covered if diagnosed by your veterinarian. Training for competitive events will never be a basis of reimbursement.
Certain preventable conditions may have coverage exclusions. For example, heartworm exclusion may be recommended in high-prevalence areas if heartworm prevention has not been administered. Pet insurers rarely cover parvovirus or other conditions in unvaccinated puppies. For your pet insurance to cover treatment for preventable conditions, you must document that you've taken reasonable measures to protect your puppy from harm.
Before enrollment, cautiously review the policy documents. Be sure to ask the insurers specific questions about borderline cases. Follow up with written clarification for ambiguous exclusions. This will provide extra protection for any unexpected claim denials. Knowing the exclusions will help you leverage the value of your policy.
Read the full article: 10 Essential Pet Insurance Benefits Explained
